Peace Corps Sued Over Mental Health Policy

The New York Times

By Ellen Barry

Sept. 27, 2023

Applicants have challenged the Peace Corps practice of rescinding invitations to applicants on the basis of mental health conditions.

Lea Iodice was thrilled to hear that the Peace Corps had accepted her application and was sending her to Senegal as a community health care worker. She shared the good news with her roommates, her family and her favorite professor and daydreamed about her last day at her job, managing a gym called SnapFitness.

She was crushed, about a month later, to receive a letter from the Peace Corps Office of Medical Services saying that her offer was being rescinded because she was in treatment for anxiety. Though she had been in therapy to manage occasional panic attacks, she had never taken any psychiatric medication, been hospitalized or engaged in any kind of self-harm.

“The reason for medical nonclearance is that you are currently diagnosed with an unspecified anxiety disorder,” read the letter, which appeared in her online application portal. “You indicated that your anxiety symptoms of increased heart rate and queasiness recur during periods of stress, which is likely to occur during service.”

Searching online, Ms. Iodice discovered that her experience was not uncommon. For years, comparing notes under anonymous screen names, Peace Corps applicants have shared stories about being disqualified because of mental health history, including common disorders like depression and anxiety.

The practice is the subject of a lawsuit filed this week in federal court, accusing the Peace Corps of discriminating against applicants with disabilities in violation of the Rehabilitation Act, which prohibits discrimination in programs receiving federal funds.

The lawsuit, which is seeking class-action status from the U.S. District Court for the District of Columbia, includes accounts from nine people whose Peace Corps invitations were rescinded for mental health reasons. The suit alleges that those decisions were made without considering reasonable accommodations or making individualized assessments based on current medical knowledge.

In a statement, a Peace Corps official said he could not comment on pending litigation, but added that “the health, safety and security of Volunteers are the Peace Corps’s top priority.”

“The agency has a statutory responsibility to provide necessary and appropriate medical care for Volunteers during service,” said Jim Golden, acting associate director of the Office of Health Services, in a statement. “Many health conditions — including mental health care — that are easily managed in the U.S. may not be able to be addressed in the areas where Peace Corps Volunteers are assigned.”

He said each candidate’s medical history is assessed individually to determine whether the agency can support the individual’s needs.

The three plaintiffs in the lawsuit are not identified by name in the court filings. But other Peace Corps applicants described rescinded offers as a major blow at a vulnerable time in their lives, throwing post-college plans into doubt and forcing them to explain to family, friends and supporters that they had been rejected because of a mental health condition.

“It was really heartbreaking to be dismissed like that,” said Ms. Iodice, now 26, who is not a party to the lawsuit. “It took a lot of processing to get over the initial feeling of unworthiness.”

The Peace Corps medically screens accepted applicants before sending them overseas to ensure that they do not face health crises when they are in locations where specialized care may not be available. Similar screenings are used in the State Department and the military.

But those policies are coming under pressure from legal activists. Early this year, the State Department agreed to pay $37.5 million to settle a class-action lawsuit, filed 16 years ago, challenging a hiring requirement that an applicant should be able to work in any State Department overseas post without the need for ongoing medical treatment.

In recent years, the Peace Corps has deployed around 7,000 volunteers to more than 60 nations, according to recent figures from the Congressional Research Service. A review of the medical clearance system found that, in 2006, around 450 applicants were medically disqualified from serving.

“I was shocked, at first, at how broad and antiquated some of these policies seem,” said Megan Schuller, legal director of the Bazelon Center for Mental Health Law, which, along with Bryan Schwartz Law, is representing the plaintiffs.

One party to the lawsuit filed on Tuesday, Teresa, 22, who asked to be identified by her middle name out of concern that stigma would damage her employment prospects, had been accepted this past January for a volunteer position in Mexico working on climate change awareness.

In March, before her planned departure, she was told that she had failed her medical clearance because of her history of treatment for anxiety and depression. She appealed the decision but was denied.

Like many undergraduates, she had struggled during the isolation of the pandemic and attended therapy and took an antidepressant medication in 2020, never considering that these treatments might disqualify her from serving in the Peace Corps, she said.

“There was part of me that thought, This can’t happen,” she said. “I do not know a single person throughout my whole college experience who didn’t struggle with their mental health.”

The letter informing her of her nonclearance cited “active symptoms of anxiety, increased heart rate, inability to sit still, inability to say no,” all symptoms noted down by her therapist in 2021, she said. She spent the weeks around college graduation explaining, again and again, that she wouldn’t be going to Mexico after all.

“It’s really humiliating to tell people that you got in and were then rejected because of your mental health,” said Teresa, who is now training to be a paralegal.

Another party to the case, Anne, 34, who also asked to be identified by her middle name out of concern for stigma, was offered a Peace Corps position in Mongolia teaching at the university level.

On her medical clearance forms, she shared that she had made two suicide attempts at age 15, she said in an interview. Since then, however, she had lived abroad as an exchange student and worked for more than a decade as a public school English teacher with no recurrence of suicidal behavior.

Her rejection letter, which arrived in November, said that she was assessed as a high risk for a recurrence of suicidal behavior. She scrambled to appeal the decision but was denied.

“When you get a denial based on something from half your life ago, it feels like a punishment for being honest, and it feels like part of your past that you can’t escape,” said Anne, who teaches at a high school. “I was very upset. I was confused and trying to figure out how to do it — to save this dream.”

Complaints over the policy have simmered for years in online forums and were the subject of a Change.org petition in 2019 and coverage this year in Worldview magazine, a news site for the National Peace Corps Association.

Applicants are increasingly forthcoming in discussing their experiences with medical clearance, said Jade Fletcher-Getzlaff, 33, who outlined her own denial and successful appeal in a YouTube video in 2019.

With each wave of deployments, she said, she receives between five and 10 inquiries from applicants who have been disqualified because of mental health conditions.

“As more people are seeking therapy, and more openly talking about these issues, I think it may be coming up more often,” she said in an interview from Japan, where she now teaches, after serving as a Peace Corps volunteer in Cambodia.

Rates of anxiety and depression among young U.S. adults have risen sharply in recent years.

In 2020, a Centers for Disease Control and Prevention study found that 63 percent of adults aged 18 to 24 years reported mental health symptoms, compared with 31 percent of all adults. Young adults also expressed greater need for mental health treatment, with 41 percent of adults aged 19 to 25 reporting unmet needs, compared with 26 percent of all adults.

Kirstine Schatz, 24, who is currently serving as a Peace Corps volunteer in Morocco, said she was initially denied a medical clearance because she took sertraline, a common antidepressant, for six months on the recommendation of her primary care physician.

She discontinued the medication seven months before applying and never received any mental health diagnosis, she said, but she was informed that she was denied medical clearance because the stressful environment of the Peace Corps might trigger a relapse.

Ms. Schatz appealed the decision, emphasizing that she had been off the medication and stable for six months, and the decision was overturned. She urged the agency to change its screening policy. “They are missing out on so many amazing people because of this archaic mind-set they have on mental health,” she said. “It’s 2023. They need to figure it out.”

As for Ms. Iodice, she never appealed her initial rejection and is still at SnapFitness, where she is the general manager. She said she had no regrets about receiving therapy, even though it might have kept her from serving with the Peace Corps in Senegal.

“If I had applied before I went to therapy, I could have gotten there, but I would have been a way worse worker, in my opinion,” she said. “In my perspective, I am a stronger person. I know myself better. I know how to cope.”